Provider Demographics
NPI:1467815407
Name:WILLIAM HARRIS,DDS,LLC
Entity Type:Organization
Organization Name:WILLIAM HARRIS,DDS,LLC
Other - Org Name:PATRIOT FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:615-507-4000
Mailing Address - Street 1:1101 ALEXANDER CIR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37208-1505
Mailing Address - Country:US
Mailing Address - Phone:615-507-4000
Mailing Address - Fax:
Practice Address - Street 1:1715 WILMA RUDOLPH BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-6861
Practice Address - Country:US
Practice Address - Phone:931-645-2469
Practice Address - Fax:931-551-9954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-29
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN95501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty